Genetic basis of nonresponse to hepatitis B vaccine in hemodialyzed patients.
Genetic factors are implicated in the response of normal subjects to hepatitis B vaccine. The aim of our study was to investigate if HLA Class I and II proteins could participate in a nonresponse to this vaccine in immunocompromised, namely hemodialyzed, patients. One hundred and seven hemodialyzed patients (68 men and 39 women, mean age 35 years) were vaccinated with Pasteur Hevac B vaccine, with a mean delay of 2 months following the onset of chronic hemodialysis. Patients were considered nonresponders when their serum antiHBs remained less than 10 mUI/ml on at least two occasions within the 12 months following the vaccination. HLA-A, B and DR antigens were determined by complement-dependent microlymphotoxicity. Ninety patients (84%) were responders and 17 (16%) nonresponders. The HLA-A1, B8 and DR3 frequency was higher in nonresponders (35, 35 and 44%, respectively) than in responders (18, 4 and 14%, respectively). The extended haplotype HLA-A1, B8, DR3 was more frequent in the former (19%) than in the latter (2%) (p less than 0.03). There was only one female within the nonresponders (6%) as compared to 37 (41%) in the responders (p less than 0.05). We conclude that genetic determinants (sex and HLA markers) play a critical role in the induction of an antiHBs immune response in both immunoincompetent hemodialyzed patients and normal immunocompetent hosts.
Pol
S
S
Unité d'Hépatologie, Hôpital Laënnec, Paris, France.
Legendre
C
C
Mattlinger
B
B
Berthelot
P
P
Kreis
H
H
D000293:Adolescent; D000328:Adult; D000917:Antibody Formation / Q000235:genetics*; D005260:Female; D015234:HLA-A Antigens / Q000032:analysis / Q000276:immunology; D015235:HLA-B Antigens / Q000032:analysis / Q000276:immunology; D006684:HLA-DR Antigens / Q000032:analysis / Q000276:immunology; D006509:Hepatitis B / Q000235:genetics / Q000276:immunology / Q000517:prevention & control*; D006515:Hepatitis B virus / Q000276:immunology; D015395:Histocompatibility Antigens Class I / Q000502:physiology; D000949:Histocompatibility Antigens Class II / Q000502:physiology; D006801:Humans; D007121:Immunocompetence / Q000235:genetics / Q000276:immunology; D007167:Immunotherapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D014612:Vaccines / Q000276:immunology*
D015234:HLA-A Antigens; D015235:HLA-B Antigens; D006684:HLA-DR Antigens; D015395:Histocompatibility Antigens Class I; D000949:Histocompatibility Antigens Class II; D014612:Vaccines